Healthcare Provider Details

I. General information

NPI: 1962581017
Provider Name (Legal Business Name): CARLOS ARTURO NOGUERA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CARLOS A NOGUERA MD PA

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 11/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 SW 13TH AVE SUITE 200
MIAMI FL
33135-2479
US

IV. Provider business mailing address

2234 COLONIAL BLVD ATTN: PAYER CONTRACTING & RELATIONS DEPT.
FORT MYERS FL
33907-1412
US

V. Phone/Fax

Practice location:
  • Phone: 305-642-6966
  • Fax: 305-642-6965
Mailing address:
  • Phone: 239-931-7342
  • Fax: 239-931-7385

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME97150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: